¿Por qué los pacientes no responden a los fármacos en el tratamiento de la disfunción eréctil?

Las dos razones principales por las que los pacientes con disfunción eréctil no responden a los fármacos son: el uso incorrecto y/o la falta de eficacia del medicamento. El motivo más frecuente de la incorrecta utilización es por el asesoramiento insuficiente por parte del médico. Entre las principales causas de un uso incorrecto están: no utilizar la estimulación sexual suficiente o la dosis adecuada del fármaco o no esperar la cantidad de tiempo suficiente entre la toma de la medicación y el intento de coito.
Otro punto importante es que el paciente debe probar al menos de cuatro a seis intentos con ese fármaco para valorar su eficacia. Una sola toma nunca será suficiente.

El aprostadilo en crema es una alternativa de primera línea al tratamiento farmacológico con un rápido inicio de acción (pocos minutos), acción local y apenas efectos locales y sistémicos. A diferencia de los fármacos orales, el alprostadilo en crema no precisa de estímulos erectógenos para tener la erección puesto que difunde directamente desde la uretra a los cuerpos cavernosos del pene. Dado su efecto local, este medicamento aporta una mejora de la función eréctil en una amplia población de varones con DE (pacientes mayores de 65 años, con enfermedades, no respondedores a los tratamientos con fármacos, pacientes después de prostatectomía radical, diabéticos, hipertensos y con enfermedad cardiovascular). Además, puede emplearse en pacientes en tratamiento con fármacos cardíacos y una ventaja es que no se ve interferido por alimentos ricos en grasa o alcohol.

Las ondas de choque de baja intensidad en los cuerpos cavernosos pueden mejorar la disfunción eréctil de causa vascular. Múltiples publicaciones están evidenciando la mejoría de la capacidad eréctil del varón. Su efecto se basa en la mejora de la circulación sanguínea del pene. Es un tratamiento rápido, sencillo e indoloro. El paciente precisa de varias sesiones de corta duración.

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